Disability Benefits for Severe TMJ

Temporomandibular joint disorders (commonly called TMJ or TMD) occur when there's a problem with the jaw, jaw joint, and surrounding facial muscles that control chewing and jaw movement. TMJ is often caused by teeth grinding (called "bruxism"), which can wear down the teeth or lead to arthritis, or injury to one or both of the temporomandibular joints (the joints that connect your lower jaw to your skull).

Those with TMJ can usually manage their symptoms through self-care, including things like:

• avoiding hard foods
• icing their jaw, or
• taking over-the-counter medications when in pain.

But if your TMJ is left untreated, it can affect other parts of your body and can lead to disability. If your TMJ is severe enough that it affects your ability to work, you might qualify for disability benefits like Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Disabling Symptoms of More Severe TMJ

Symptoms of severe TMJ can include:

• frequent locking of your jaw or difficulty opening your mouth
• tinnitus (ringing in your ear) or earaches
• a change in the way the teeth fit together
• tooth sensitivity
• severe pain in your head or neck, and
• postural changes that can lead to back pain.

People who suffer from temporomandibular joint disorders are also more likely to have migraines or restless leg syndrome.

Qualifying for Disability Benefits Based on TMJ

There are two ways to qualify for disability benefits through the Social Security Administration (SSA):

• Show that you meet or equal the requirements of one of Social Security's listed disabilities.
• Prove that you can't work in any type of job and that your inability to work has lasted or is expected to last a least a year.

Is TMJ a Disability According to Social Security?

Social Security's "Blue Book" is a list of impairments that can automatically qualify you for disability benefits. To "meet a listing," you must prove that you have a listed impairment and the symptoms or test results required in the impairment listing.

There's no specific listing for TMJ in the Blue Book, so Social Security won't automatically consider it a disability. But, if your TMJ is severe enough to cause serious impairments, you might be able to meet a listing for a related condition, such as:

• listing 2.07: Disturbance of labyrinth-vestibular function, if you suffer from vertigo
• listing 2.08: Loss of speech, if your speech is impaired because you can't properly use your mouth to speak
• listing 2.09: Hearing loss, if you've suffered some hearing loss, tinnitus might play a role in further limiting your ability to hear, or
• listing 5.08: Weight loss, if you have difficulty eating due to extremely limited jaw movement.

Proving You Can't Work Due to Limitations Caused by TMJ

Even with severe TMJ, your symptoms probably won't be enough to meet a listing. So, you're more likely to qualify for disability benefits by proving your TMJ symptoms and limitations prevent you from working.

To decide whether you should be able to work, Social Security looks at your physical, mental, and sensory impairments and abilities. The SSA then creates a residual functional capacity (RFC) assessment for you.

If your RFC indicates that you can't do even sedentary work, you'll meet the medical requirements for disability. Or, if you're an older worker with little education, you might qualify even with an RFC indicating you can do sedentary work. (Learn more about how your age can affect your disability claim.)

How TMJ Might Affect Your RFC

Your RFC is the most you can be expected to do for a sustained time in a work environment. In other words, it dictates the kind of full-time work you can do despite the limitations your TMJ causes.

Social Security determines your physical and mental RFC based on the medical evidence in your file. So make sure your records include a doctor's statement explaining all your limitations and how your TMJ causes them. (Learn more about getting your doctor's help with your disability claim.)

Assessing Your Physical Limitations Caused by TMJ

In determining your physical RFC, Social Security assesses your physical abilities and limitations, such as your ability to:

• lift, reach overhead, and carry objects
• do work with your hands (including non-exertional activities like typing and filing papers), and
• walk, stand, and sit for periods of time.

With severe TMJ, the pain in your neck, head, and/or ears might limit your ability to perform exertional activities due to discomfort when performing such tasks. For example, your ability to lift and carry boxes might be limited due to neck and back pain.

Likewise, your physical limitations could affect your ability to perform non-exertional activities. For instance, you might have severe neck pain that worsens if you type on a keyboard for any length of time.

Social Security will consider how your chronic pain affects your daily functioning. But for your pain to have an impact on your RFC, Social Security will need to see medical test results that adequately explain the level of pain you're experiencing. In other words, the Social Security medical consultant on your case must agree that TMJ could reasonably create the symptoms you're experiencing.

Learn more about how Social Security evaluates chronic pain.

How Social Security Considers the Sensory Impairments of TMJ

The sensory abilities Social Security assesses for your RFC include how well you can hear and speak and your ability to function in various work situations.

Hearing and speech impairments could affect your ability to work in certain environments. For example, if you can't speak clearly, you might be unable to perform jobs that include a lot of time on the telephone. Or if you have a hearing impairment due to TMJ, it might affect your ability to interact effectively with others in the workplace. A hearing impairment might also hinder your ability to understand verbal instructions.

Additionally, the light sensitivity that can accompany headaches and other impairments caused by TMJ might limit the places where you can work.

The Effect of TMJ on Your Mental Functioning

In addition to evaluating your physical abilities, Social Security also assesses your mental functioning, such as your ability to do the following:

• understand and complete tasks as assigned
• concentrate and maintain a productive pace
• function in the workplace with others, and
• tolerate stress.

Some of your physical limitations might affect your mental functioning on the job. The jaw pain and headaches of TMJ could also affect your ability to maintain attention and concentrate on your work. And it's not uncommon for someone suffering from a chronic medical condition like TMJ to also struggle with mental health issues like depression or anxiety. Having a mental health problem can cause symptoms like pain to have a greater impact on your ability to function.

Be sure any mental limitations that you have are documented alongside your physical limitations of TMJ in your medical records. Social Security must consider the combined effect of all your limitations on your ability to work.

Learn more about how mental health issues can strengthen your disability claim.

How to Apply for Disability Based on TMJ

The fastest way to file your Social Security disability claim is to complete an online application. You can access the online application anytime (day or night) from anywhere (including outside the United States) at a time that's convenient for you. Plus, you can stop and restart the online application process as often as needed without losing your place.

If you don't want to apply for benefits online, you can call Social Security at 800-772-1213 and make an appointment to apply by phone. Or apply in person at your local Social Security office. (Avoid a long wait by contacting your local office first to make an appointment.)

Learn more about the disability application process, including the documents and information Social Security will require.

Getting VA Disability for TMJ

Unlike Social Security, the Department of Veterans Affairs (VA) does list temporomandibular joint disorders in its list of disabilities. TMJ is included in the VA's Schedule for Rating Disabilities under dental and oral conditions, diagnostic code "9905 Temporomandibular disorder (TMD)."

The VA rating for TMJ is based on how much the disorder affects your ability to move your jaw. (38 C.F.R. § 4.150.) Specifically, the VA looks at:

• how wide you can open your mouth (unassisted)
• how much side-to-side movement you have, and
• whether your limited vertical movement causes dietary restrictions (like only being able to eat food that's been mashed, or being on a liquid diet).

The VA disability ratings for TMJ range from 10% to 50%, but calculating a VA rating for TMJ is fairly complicated. Dietary restrictions increase a rating based on limited vertical movement (how wide you can open your mouth). For VA compensation purposes, only vertical movement limited to 34 mm or less can receive a 10% or better rating.

For example, if you can open your mouth more than 34 mm, but your side-to-side (lateral) motion is limited to 4mm, you'd receive a 10% disability rating. If you can only open your mouth to 10 mm and are restricted to a diet of "mechanically altered" food (food that's blended, ground, or mashed), your disability rating for TMJ would be 50%.

If you had a 50% rating because of your vertical movement limitations and your lateral motion was limited to 4mm or less, your rating would still be 50%. That's because the VA doesn't allow you to combine your rating for limited lateral movement with your rating for limited vertical movement.

Learn more about the eligibility requirements for VA disability compensation.